Donation after Circulatory Death Lung Activity in the UK – 100 Transplants and Counting

Thomas, Helen, Taylor, Rhiannon, Simon, Andre, Clark, Stephen, Dunning, Joel, Yonan, Nizar, Banner, Nicholas and Dark, John (2013) Donation after Circulatory Death Lung Activity in the UK – 100 Transplants and Counting. The Journal of Heart and Lung Transplantation, 32 (S4). S15. ISSN 1053 2498

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Abstract

Purpose
Whilst the number of donors after brain death (DBD) suitable for lung donation has decreased in the UK over the last ten years, the number of suitable donors after circulatory death (DCD) has increased by 346%. Four of the five adult lung centres in the UK now transplant DCD lungs, with 100 DCD lung transplants now performed. This study aims to examine the differences in donor, recipient and transplant characteristics between the two donor groups and compare the post-transplant outcome.

Methods and Materials
Data on all adult lung only transplants performed in the UK between January 2002 and October 2012 were obtained from the UK Transplant Registry. Transplant characteristics and outcome were compared using the Wilcoxon, chi-squared or log-rank tests, as appropriate.

Results
Over the last ten years, 1452 adult lung only transplants were performed in the UK, of which 100 (7%) involved DCD lungs. Over the last three years DCD lung transplants accounted for 14% of activity, which is similar to the DCD activity in Australia and the Netherlands. Where data were available, DCD lung transplants were all performed from controlled DCD, and the majority (87%) were not certified dead by brain stem tests. 84% of DCD lung transplants were bilateral sequential lung transplants (BSLT) compared with 72% of DBD lung transplants (p=0.01). In univariate analysis, DCD transplants also had significantly longer ischaemia times (p<0.0001), more donors dying due to ‘other’ reasons (p=0.005), younger recipients (p=0.01) and, for BSLT, a higher maximum FEV1 at 1 year (p=0.03). There was no significant difference in post-transplant survival, with one-year survival of 79.2% (95% CI 76.8, 81.4) in the DBD group and 79.5% (95% CI 68.8, 86.8) in the DCD group (p=0.9).

Conclusions
DCD lung transplant activity has increased dramatically over the last ten years and now accounts for 14% of all UK adult lung only transplant activity. With the continuing shortage of DBD organs, DCD lungs provide a valuable additional resource with equivalent outcomes.

Item Type:	Article
Subjects:	B100 Anatomy, Physiology and Pathology
Department:	Faculties > Health and Life Sciences > Applied Sciences
Depositing User:	Becky Skoyles
Date Deposited:	06 May 2015 15:10
Last Modified:	12 Oct 2019 18:28
URI:	http://nrl.northumbria.ac.uk/id/eprint/22302

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